ALTA BATES SUMMIT MEDICAL CENTER (NPI# 1043358542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043358542 |
| Entity Type | Organization |
| Organization Name | ALTA BATES SUMMIT MEDICAL CENTER |
| Other Organization Name | MERRITT PERALTA INSITITUTE |
| Practice Address |
350 Hawthorne Ave Oakland CA 94609-3108 |
| Mailing Address |
Po Box 742920 Los Angeles CA 90074-2920 |
| Practice Telephone | 5108698850 |
| Mailing Telephone | 8553981633 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2016-04-21 |
| Authorized Official Name | JOHN GATES (CFO SHBA) |
| Authorized Official Telephone | 5104507357 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | 140000232 | CA | Hospital Units |
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | CA | Hospital Units |
| Other Name | Type Code |
|---|---|
| Merritt Peralta Insititute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649720954 | Alta Bates Summit Medical Center | General Acute Care Hospital | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2016-10-11 |
| 1336529106 | Alta Bates Summit Medical Center | Clinic/Center | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2015-06-05 |
| 1780813485 | Alta Bates Summit Medical Center | Pharmacy | 3100 Summit St, Oakland, CA 94609-3412 | 2009-07-02 |
| 1457489502 | Alta Bates Summit Medical Center | Psychiatric Hospital | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2007-03-01 |
| 1922140771 | Alta Bates Summit Medical Center | General Acute Care Hospital | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2007-02-12 |
| 1720128556 | Alta Bates Summit Medical Center | General Acute Care Hospital | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2007-02-08 |
| 1639219462 | Alta Bates Summit Medical Center | General Acute Care Hospital | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2007-02-08 |
| 1316088024 | Alta Bates Summit Medical Center | General Acute Care Hospital | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2007-02-08 |
| 1376625277 | Alta Bates Summit Medical Center | Psychiatric Unit | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2006-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ALTA BATES SUMMIT MEDICAL CENTER | 350 Hawthorne Ave, Oakland, CA 94609-3108 |
| Street Address |
350 HAWTHORNE AVE |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831181114 | Fredric K. Chin | Radiology | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2005-08-22 |
| 1619597887 | Ngan Ki Lai | Pharmacist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2020-04-17 |
| 1619528452 | Catherine Datu | Occupational Therapist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2019-09-24 |
| 1376194183 | Yenlinh Thi Bui | Pharmacist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2019-09-23 |
| 1376190405 | Monique Marie Adams | Physical Therapist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2019-08-22 |
| 1174099519 | Jesse Morris | Physical Therapist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2018-10-23 |
| 1619476348 | Emily Jane Medeiros | Pharmacist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2018-02-08 |
| 1023525136 | Kerry Canton | Occupational Therapist | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2018-01-10 |
| 1841709979 | Kristin Burgess Mcbride | Emergency Medicine | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2017-09-20 |
| 1073037610 | Erica Chang | Nurse Practitioner | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2017-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578764379 | Alameda Health System | Rehabilitation, Substance Use Disorder Unit | 1411 E 31st St, Oakland, CA 94602-1018 | 2007-05-30 |
| 1831244748 | Kaiser Permanente | Rehabilitation, Substance Use Disorder Unit | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245841766 | Los Angeles Centers for Alcohol and Drug Abuse | Rehabilitation, Substance Use Disorder Unit | 305 S Central Ave, Los Angeles, CA 90013-1709 | 2020-08-10 |
| 1760002299 | Avalon Outpatient Services | Rehabilitation, Substance Use Disorder Unit | 1547 N Avalon Blvd, Wilmington, CA 90744-1552 | 2020-04-24 |
| 1356960512 | Los Angeles Centers for Alcohol and Drug Abuse | Rehabilitation, Substance Use Disorder Unit | 8919 California Ave, South Gate, CA 90280-3013 | 2020-04-08 |
| 1144860073 | Starbridge Recovery, LLC | Rehabilitation, Substance Use Disorder Unit | 3943 Fredonia Dr, Los Angeles, CA 90068-1213 | 2020-01-08 |
| 1376190918 | Psychnp Consultants, Inc | Rehabilitation, Substance Use Disorder Unit | 8500 Crown Prince Ct, Elk Grove, CA 95624-1779 | 2019-08-19 |
| 1679126247 | Imperial County Behavioral Health Services | Rehabilitation, Substance Use Disorder Unit | 101 Hacienda Dr, Calexico, CA 92231-1889 | 2019-07-22 |
| 1831653617 | Journey Hillside Tarzana, LLC | Rehabilitation, Substance Use Disorder Unit | 4706 Viviana Dr, Tarzana, CA 91356-5039 | 2019-01-25 |
| 1205331709 | Recovery Corps Health Group, LLC | Rehabilitation, Substance Use Disorder Unit | 422 N Commonwealth Ave, Los Angeles, CA 90004-2301 | 2018-03-27 |
| 1124523618 | Recovery Corps, LLC | Rehabilitation, Substance Use Disorder Unit | 424 N Commonwealth Ave, Los Angeles, CA 90004-2301 | 2018-03-27 |
| 1063929602 | Recovery Corps, LLC | Rehabilitation, Substance Use Disorder Unit | 420 N Commonwealth Ave, Los Angeles, CA 90004-2301 | 2018-01-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.